SWIMSAFER Provider Programme registration form
Principle programme providers Water Safety NZ, ASCTA, PJ Mask, SCTNZ. Register now to become a SWIMSAFER provider www.sctnz.com
SWIMSAFER provider programme name:
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Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Programme website URL:
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Primary phone contact for the SWIMSAFER programme
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Contact email (this will not be published)
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Swim School contact for booking purposes (phone or email) (indicate if you wish this to be published with Y or N)
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Secondary contact person for SWIMSAFER purposes - if applicable, provide email and phone contact details below
Do you have more than one Swim School
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Yes
No
Each participating programme and relevant web address/es will be listed on the SWIMSAFER website if they differ from the primary contact. These are required for delivery of SWIMSAFER printed posters.
Please note: to become a SWIMSAFER provider, you need to hold a current 2023/24 SCTNZ membership as either a Site Member, Teacher or Coach. Please complete the following;
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Yes, I am a current Site Member of SCTNZ
Yes, I am a current Swim Teacher member of SCTNZ
Yes, I am a current Swim Coach member of SCTNZ
No I am not currently a financial member
My SCTNZ membership number is:
If you are NOT a current member complete the following; www.sctnz.com to register now
I wish to join SCTNZ for the 2023/24 financial year; Once this is completed and submitted your SWIMSAFER registration will be processed. OR
For SCTNZ knowledge, please complete the following; I intend to join SCTNZ in 2023/24 as;
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Swim School Site Member (list the number of teachers in your programme)
Swim Teacher
Swim Coach
Submit
Should be Empty: